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Daozhou Gao Abdou Amza Baidou Nassirou Boubacar Kadri Nicholas Sippl-Swezey Fengchen Liu Sarah F. Ackley Thomas M. Lietman Travis C. Porco 《The American journal of tropical medicine and hygiene》2014,91(5):936-942
Mass administration of azithromycin for trachoma has been shown to reduce malarial parasitemia. However, the optimal seasonal timing of such distributions for antimalarial benefit has not been established. We performed numerical analyses on a seasonally forced epidemic model (of Ross-Macdonald type) with periodic impulsive annual mass treatment to address this question. We conclude that when azithromycin-based trachoma elimination programs occur in regions of seasonal malaria transmission, such as Niger, the optimal seasonal timing of mass drug administration (MDA) may not occur during the season of maximum transmission. 相似文献
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Amza Abdou Beatriz E. Munoz Baido Nassirou Boubacar Kadri Fati Moussa Ibrahim Baarè Joseph Riverson Emmanuel Opong Sheila K. West 《Tropical medicine & international health : TM & IH》2010,15(1):98-104
Objective To determine the impact after 2 years of a water and health education (W/HE) programme on ocular Chlamydia trachomatis infection and trachoma.
Methods We randomized 12 trachoma-endemic communities in Maradi, Niger 1:1 to W/HE intervention and control arms and collected data on 10 of the 12 villages. In the intervention villages, at least one clean water well was constructed, and a 3 month, modest health education programme was provided immediately prior to the 2 year survey. We censused all households, and 557 children ages 1–5 years were randomly selected as sentinel children and examined at baseline and at one and 2 years from baseline. Trachoma was clinically assessed and a swab taken and analyzed for C. trachomatis . Tetracycline eye ointment was provided to all children in either arm during the surveys who had signs of trachoma.
Results Infection with C. trachomatis declined slightly, and not significantly, in the children in the control villages over the 2 years, from 15% to 11%. The decline in infection was more pronounced, and significant, in the children in the intervention villages, from 26% to 15%. However, the change in infection rates in the intervention villages was not significantly different from the change in infection rates in the control villages ( P = 0.39, and 0.11 for change from baseline to 1 year and 2 year, respectively). There was also no difference in the change in overall trachoma rates between the two arms.
Conclusion These data suggest that the provision of water plus a modest health education programme did not result in a significant difference in trachoma or ocular C. trachomatis infection in endemic communities in Niger. A more substantial health education intervention is likely necessary to produce change. 相似文献
Methods We randomized 12 trachoma-endemic communities in Maradi, Niger 1:1 to W/HE intervention and control arms and collected data on 10 of the 12 villages. In the intervention villages, at least one clean water well was constructed, and a 3 month, modest health education programme was provided immediately prior to the 2 year survey. We censused all households, and 557 children ages 1–5 years were randomly selected as sentinel children and examined at baseline and at one and 2 years from baseline. Trachoma was clinically assessed and a swab taken and analyzed for C. trachomatis . Tetracycline eye ointment was provided to all children in either arm during the surveys who had signs of trachoma.
Results Infection with C. trachomatis declined slightly, and not significantly, in the children in the control villages over the 2 years, from 15% to 11%. The decline in infection was more pronounced, and significant, in the children in the intervention villages, from 26% to 15%. However, the change in infection rates in the intervention villages was not significantly different from the change in infection rates in the control villages ( P = 0.39, and 0.11 for change from baseline to 1 year and 2 year, respectively). There was also no difference in the change in overall trachoma rates between the two arms.
Conclusion These data suggest that the provision of water plus a modest health education programme did not result in a significant difference in trachoma or ocular C. trachomatis infection in endemic communities in Niger. A more substantial health education intervention is likely necessary to produce change. 相似文献
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Souleymane Diabaté Annie Chamberland Djimon M. Zannou Nassirou Geraldo Angèle Azon-Kouanou Marguérite Massinga-Loembé 《AIDS care》2013,25(11):1426-1432
From September 2008 to December 2011, we enrolled and followed-up 247 HIV-negative, 88 untreated and 32 treated HIV-positive female sex workers (FSWs), as well as 238 untreated and 115 treated HIV-positive patients from the general population (GP) of Cotonou, Benin. We wanted to assess the effect of antiretroviral therapy (ART) on sexual risk-taking in FSWs and patients from the GP. We used multivariate log binomial regression models for repeated measures to compare risky behaviours reported during pre-ART and post-ART visits and we performed linear time-trend analyses to assess changes in condom use in all five groups. At 58.8% of pre-ART and 45.3% of post-ART visits (adjusted p-value=0.293), treated FSWs have reported ≥16 clients during the last week of work. Inconsistent condom use with clients over the same period decreased by more than 50% (from 20.7 to 10.0%, adjusted p-value=0.082). In treated patients from the GP, inconsistent condom use with regular partners during the last four months was reported at 52.8% of pre-ART and 53.5% of post-ART visits (p=0.778). Reported casual sex was stable (36.8% versus 38.7%, adjusted p-value=0.924). In linear time-trend analyses, there was a significant downward trend in inconsistent condom use at the early stage of the study and stability thereafter in all HIV-negative and HIV-positive FSWs. There was no negative alteration in sexual behaviour following ART initiation either inpatients from the GP or in FSWs. The results underscore the key role of concomitant sexual risk-reduction strategies. 相似文献
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Bruce D. Gaynor Abdou Amza Sintayehu Gebresailassie Boubacar Kadri Baido Nassirou Nicole E. Stoller Sun N. Yu Puja A. Cuddapah Jeremy D. Keenan Thomas M. Lietman 《The American journal of tropical medicine and hygiene》2014,91(3):577-579
We assessed trachoma grading agreement among field graders using photographs that included the complete spectrum of disease and compared it with cases where there was consensus among experienced graders. Trained photographers took photographs of children''s conjunctiva during a clinical trial in Ethiopia. We calculated κ-agreement statistics using a complete set of 60 cases and then recalculated the κ using a consensus set where cases were limited to those cases with agreement among experienced graders. When the complete set of 60 cases was used, agreement was moderate (κ = 0.61, 95% confidence interval [95% CI] = 0.56–0.67). When the consensus set was used, agreement improved significantly (κ = 0.75, 95% CI = 0.68–0.80). The κ of the consensus set was higher than the complete set by 0.14 (95% CI = 0.12–0.16) (P < 0.001). If testing sets remove difficult-to-grade cases, agreement in trachoma grading may be higher than actually seen in population-based trachoma surveys. 相似文献
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Bruce D. Gaynor Abdou Amza Boubacar Kadri Baido Nassirou Ousmane Lawan Laouali Maman Nicole E. Stoller Sun N. Yu Stephanie A. Chin Sheila K. West Robin L. Bailey Philip J. Rosenthal Jeremy D. Keenan Travis C. Porco Thomas M. Lietman 《The American journal of tropical medicine and hygiene》2014,90(5):846-851
We assessed the effect of mass azithromycin treatment on malaria parasitemia in a trachoma trial in Niger. Twenty-four study communities received treatment during the wet, high-transmission season. Twelve of the 24 communities were randomized to receive an additional treatment during the dry, low-transmission season. Outcome measurements were conducted at the community-level in children < 1–72 months of age in May–June 2011. Parasitemia was higher in the 12 once-treated communities (29.8%, 95% confidence interval [CI] = 21.5–40.0%) than in the 12 twice-treated communities (19.5%, 95% CI = 13.0–26.5%, P = 0.03). Parasite density was higher in once-treated communities (354 parasites/μL, 95% CI = 117–528 parasites/μL) than in twice-treated communities (74 parasites/μL, 95% CI = 41–202 parasites/μL, P = 0.03). Mass distribution of azithromycin reduced malaria parasitemia 4–5 months after the intervention. The results suggest that drugs with antimalaria activity can have long-lasting impacts on malaria during periods of low transmission. 相似文献
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Mukenge-Tshibaka L Alary M Lowndes CM Van Dyck E Guédou A Geraldo N Anagonou S Lafia E Joly JR 《Sexually transmitted diseases》2002,29(6):324-330
BACKGROUND: The syndromic diagnostic approach is the most realistic and cost-effective strategy for controlling sexually transmitted infections (STIs) in the developing world. Its potential advantages should be evaluated. GOAL: The goal of the current study was to examine whether the syndromic approach might diagnose more cases of cervicitis due to Neisseria gonorrhoeae or Chlamydia trachomatis than laboratory tests. STUDY DESIGN: The participants were 481 female sex workers in Benin, screened for STIs and treated on the basis of the clinical findings. They were asked to return to the clinic within 10 days for laboratory test results and appropriate treatment when necessary. RESULTS: The prevalence of cervical infections was 24.5%. In comparison to the gold standard, the sensitivity of the syndromic diagnosis approach for the detection of N gonorrhoeae/C trachomatis infections was 48.3%; that of the locally performed laboratory tests was 74.6%. However, the sensitivity of the laboratory tests dropped to 28.8% when it was taken into consideration that 57.6% of the infected women did not return to the clinic within 10 days. CONCLUSIONS: The syndromic diagnosis approach should continue to be used for female sex workers in Benin because returning for treatment is problematic. Presumptive treatment at their initial visit could be a complement to this approach, given the high prevalence of cervicitis in this population. 相似文献
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Augustin Kpemasse Fortune Dagnon Ramani Saliou Alexis Sacca Yarou Maye Cyriaque Dossou Affoukou Alassane Zoulkaneri Blaise Guzo-Mvo Leah F. Moriarty Yaye D. Ndiaye Mamane Nassirou Garba Awa Bineta Deme Daouda Ndiaye Aurore Ogouyemi Hounto 《The American journal of tropical medicine and hygiene》2021,105(3):670